Antimicrobial resistance is a rigorous health issue around the world. Because of the short turn-around-time and broad pathogen spectrum, culture-independent metagenomic next-generation sequencing (mNGS) is a powerful and highly efficient tool for clinical pathogen detection. The increasing question is whether mNGS is practical in the prediction of antimicrobial susceptibility. This review summarizes the current mNGS-based antimicrobial susceptibility testing technologies. The critical determinants of mNGS-based antibacterial resistance prediction have been comprehensively analyzed, including antimicrobial resistance databases, sequence alignment tools, detection tools for genomic antimicrobial resistance determinants, as well as resistance prediction models. The clinical challenges for mNGS-based antibacterial resistance prediction have also been reviewed and discussed.
Organ transplantation is a critical treatment for end-stage organ diseases, yet postoperative infections significantly affect patient outcomes. Traditional diagnostic methods for infections often fall short in meeting the demands of precise prevention and treatment due to limitations in sensitivity, specificity, and speed. Targeted nanopore pathogen sequencing technology, characterized by its long-read capability, real-time detection, and adaptability, has shown unique potential in pathogen identification, structural variation analysis, and antimicrobial resistance gene profiling. This offers new insights into the prevention and management of postoperative infections. This expert consensus focuses on the standardized application of this technology in managing infections following organ transplantation, addressing its principles, clinical recommendations, and diagnostic workflows. By exploring its features and value in infectious disease diagnosis, the expert consensus provides standardized guidance on sample processing and result interpretation. The development of this consensus aims to promote the rational use of nanopore sequencing in diagnosing and treating post-transplant infections, enhance diagnostic accuracy and efficiency, improve patient outcomes, and facilitate the widespread adoption of this technology.
This article provides a systematic interpretation of the Development and Implementation of National Action Plans for Infection Prevention and Control Practical Guide issued by the World Health Organization in 2025. Functioning as a pragmatic evolution of the 2016 Guidelines on core components of infection prevention and control programmes, this new guide aims to overcome systemic bottlenecks in transitioning from theoretical advocacy to practical implementation through a core “five-step cycle” framework. It elaborates on eight strategic pathways, including governance architecture, data-driven methodologies, and multidisciplinary synergy, while achieving high integration with the global action plan and monitoring framework. The guide offers significant benchmarks for refining infection prevention and control professional security mechanisms, enhancing the clinical translation efficacy of surveillance data, and deepening multidisciplinary integration in China. It provides theoretical support and a practical reference for constructing a high-quality modern infection prevention and control macro-governance system and formulating related policies.